Does creatine cause kidney stones?

Nobody has shown that it does, and nobody has properly tested it. We found no randomized trial and no systematic review that counted kidney stones in people taking creatine. The nearest strong evidence is about kidney function. A 2025 meta-analysis of creatine trials found a small rise in blood creatinine and no significant change in kidney filtration rate, in mostly healthy people followed for months, with data beyond one year still sparse.

Unsettled. This is a gap in the evidence rather than a reassuring result. The one published report that looks at creatine and stones in a person describes a single athlete with a past 11 mm stone who took creatine for two months and had no stone on ultrasound 14 months later. The authors themselves note that no studies of stones in people had been done. One case cannot show that creatine is safe for stone formers, and it cannot show the opposite.

What the trials found

The studies that exist measured kidney function, not stones. Those are related questions, and they are not the same question.

The 2025 meta-analysis pooled 5 studies that measured filtration rate before and after supplementation, 69 people on creatine and 74 controls, and found no statistically significant difference. Across 12 studies, serum creatinine rose by a mean of 0.07 (95% CI 0.01 to 0.12). Creatine breaks down into creatinine, so a small rise in that marker is expected. The authors write that most of the 21 studies they included were short to moderate in length.

A 2020 meta-analysis of 29 studies in 951 women found no statistically significant difference in measures of kidney or liver function. A 2019 review of 15 studies, 6 of them pooled, concluded that creatine did not cause kidney damage at the amounts and durations studied. Its own pooled numbers show creatinine and urea going up, and the card for that review flags the abstract as inconsistent, so we lean on it less than on the other two.

Two small randomized trials point the same way. In 18 healthy young men taking about 10 g a day for 3 months alongside aerobic training, cystatin C, a filtration marker other than creatinine, fell in both groups with no difference between them. In 29 older patients with peripheral artery disease, 8 weeks of creatine did not change creatinine clearance against placebo, as the chart shows. Neither trial looked for stones.

We also looked at hydration, because the worry about creatine and stones usually runs through dehydration. A 2009 systematic review of 10 randomized trials found no evidence that creatine harms heat tolerance or fluid balance in athletes at recommended doses.

One observational signal is easy to misread. In 24-hour urine from 418 first-time stone formers and 440 controls, stone formers had more creatine in their urine after adjusting for age and sex. The study abstract does not mention supplement use, so it cannot tell where that creatine came from, and an association in a case-control comparison does not show cause.

Myth. The idea that creatine damages healthy kidneys is not supported by the trials. An expert review by the International Society of Sports Nutrition concludes that creatine at recommended doses does not cause kidney damage or dysfunction in healthy people. That conclusion is about kidney function. It says nothing directly about stones.

Who should be careful

The cases of kidney harm on creatine come from case reports, which the same ISSN review says were confounded by medicines, existing kidney disease, other supplements, steroids or doses around 100 times the recommended amount. One recent case is harder to explain away. A 17-year-old athlete developed acute kidney injury with cast nephropathy, confirmed on biopsy, after a 6-day high-dose loading regimen, without muscle breakdown. The abstract does not give the dose, and it is one person.

Not for everyone. We found no trials at all in people who already have kidney disease or who form stones again and again. The ISSN conclusion covers healthy people at recommended doses and leaves these groups out. Teenagers doing high-dose loading are the one group with a recent case of acute kidney injury. If you have had a kidney stone, have reduced kidney function or take medicines that affect the kidneys, creatine is a question for the person treating you. Because creatine raises blood creatinine slightly, tell them you take it before a kidney blood test.

What expert bodies say

The ISSN expert review is the only body position we found on creatine and the kidneys. It concludes that recommended doses do not cause kidney damage in healthy people and says nothing specific about stones. The NIH Office of Dietary Supplements has no creatine fact sheet, and we found no position on creatine and stones from a kidney or food safety agency.

How we searched

What would change this answer

• A cohort that links creatine supplement use to new kidney stones. Large national surveys already ask about both, and nobody has put them together.
• A trial that measures the urine chemistry behind stones, oxalate, citrate and calcium, in people taking creatine, ideally including people who have formed a stone before.
• A small trial now recruiting at the University of Northern Iowa is giving creatine before exercise in the heat and measuring a urinary marker of kidney stress. It does not measure stones, and it is the first trial to test kidney stress under dehydration on creatine.

More on creatine itself, including food sources and what else it is claimed to do: Creatine.

Sources

1. ev-crks-01 · Laboratory or animal data · case report · n = 1
   Two months of creatine monohydrate supplementation in an athlete with a history of kidney stones could not be associated with kidney stone recurrence in the long run.
   
   Who: healthy young athlete with a previous kidney stone treated by lithotripsy
   Effect: no stone recurrence on renal ultrasound 14 months after 2 months of creatine monohydrate
   Certainty: A single case; the dose is not stated in the abstract; the authors themselves say there were no stone studies in humans.
   Tunis Med, 2022 · checked 2026-10-07 · we read the abstract
2. ev-crks-02 · Meta-analysis or systematic review · systematic review and meta-analysis · n = 143
   A total of 5 studies evaluating GFR before and after intervention were included in the meta-analysis. ... The meta-analysis revealed a non-statistically significant differences in GFR following creatine supplementation compared to control.
   
   Who: people taking creatine supplements vs placebo or control; 5 studies with 69 creatine and 74 control participants in the GFR analysis
   Effect: GFR: no statistically significant difference vs control; serum creatinine MD 0.07 (95% CI 0.01 to 0.12) in 12 studies
   Certainty: Not about stones; mostly healthy people, short and medium terms; data beyond a year are meager.
   BMC Nephrol, 2025 · checked 2026-10-07 · we read the fulltext
3. ev-crks-03 · Meta-analysis or systematic review · systematic review and meta-analysis, limitations section · n = 21 studies
   Most included studies were of short to moderate duration; long-term safety data beyond one year remain sparse.
   
   Who: creatine supplementation trials reporting kidney outcomes
   Effect: long-term (over 1 year) kidney safety data sparse
   Certainty: Knowledge boundary: few long studies, and stones as an outcome are not in them.
   BMC Nephrol, 2025 · checked 2026-10-07 · we read the fulltext
4. ev-crks-04 · Meta-analysis or systematic review · systematic review and meta-analysis · n = 15 studies (6 in meta-analysis)
   The findings indicate that creatine supplementation does not induce renal damage in the studied amounts and durations.
   
   Who: studies of creatine supplementation reporting serum creatinine and urea
   Effect: serum creatinine SMD 0.48 (95% CI 0.24 to 0.73); urea SMD 1.10 (0.34 to 1.85)
   Certainty: The abstract is contradictory: it says 'did not change', while the CIs show increased markers; the authors' conclusion is no damage.
   J Ren Nutr, 2019 · checked 2026-10-07 · we read the abstract
5. ev-crks-05 · Meta-analysis or systematic review · systematic review and meta-analysis · n = 951
   No statistically significant difference was reported in measures of renal or hepatic function.
   
   Who: female participants in creatine monohydrate trials that monitored adverse outcomes
   Effect: total adverse events RR 1.24 (95% CI 0.51 to 2.98); no significant difference in renal function measures
   Certainty: Stones were not analyzed separately; adverse event reporting is incomplete.
   Nutrients, 2020 · checked 2026-10-07 · we read the abstract
6. ev-crks-06 · Randomized controlled trial(s) · randomized, double-blind, placebo-controlled trial · n = 18
   The decrease in cystatin C indicates that high-dose creatine supplementation over 3 months does not provoke any renal dysfunction in healthy males undergoing aerobic training.
   
   Who: healthy sedentary males 18-35 years, moderate aerobic training, 3 months
   Effect: cystatin C fell in both groups (CR 0.82 to 0.71 mg/L; placebo 0.88 to 0.75); no between-group differences
   Certainty: Small sample; stones were not assessed.
   Eur J Appl Physiol, 2008 · checked 2026-10-07 · we read the abstract
7. ev-crks-07 · Randomized controlled trial(s) · randomized, double-blind, placebo-controlled trial · n = 29
   Eight weeks of creatine supplementation is safe and does not compromise the renal function of patients with peripheral arterial disease.
   
   Who: patients with symptomatic peripheral arterial disease, both genders; creatine 20 g/day 1 week then 5 g/day 7 weeks
   Effect: creatinine clearance CR 108 to 117 vs placebo 88 to 82 mL/min/1.73 m2, P = 0.366
   Certainty: Small sample, 8 weeks; stones were not assessed.
   Ann Vasc Surg, 2020 · checked 2026-10-07 · we read the abstract
8. ev-crks-08 · Meta-analysis or systematic review · systematic review with meta-analyses of randomized clinical trials · n = 10 studies
   No evidence supports the concept that creatine supplementation either hinders the body's ability to dissipate heat or negatively affects the athlete's body fluid balance.
   
   Who: athletes exercising in the heat; randomized clinical trials of creatine
   Effect: no adverse effect on thermoregulation or body fluid balance at recommended dosages
   Certainty: About hydration, not stones; the link to stones is indirect.
   J Athl Train, 2009 · checked 2026-10-07 · we read the abstract
9. ev-crks-09 · Observational data · case-control comparison within a prospective cohort · n = 858
   Among NMR urine metabolites, stone formers had lower hippuric acid, trigonelline, 2-furoylglycine, imidazole, and citrate and higher creatine and alanine.
   
   Who: first-time symptomatic kidney stone formers and controls, prospective cohort; 24-hour urine NMR metabolomics
   Effect: higher urine creatine in stone formers after adjustment for age and sex
   Certainty: Endogenous creatine in urine, supplement intake not assessed; association does not mean cause.
   J Am Soc Nephrol, 2022 · checked 2026-10-07 · we read the abstract
10. ev-crks-10 · Laboratory or animal data · case report · n = 1
    This case underscores the potential risks of high-dose creatine use in adolescents and highlights the importance of kidney function monitoring in athletes using sports supplements.
    
    Who: 17-year-old male athlete, 6-day high-dose creatine loading
    Effect: acute kidney injury with cast nephropathy confirmed on biopsy; bilateral flank pain
    Certainty: A single case; not stones, but a similar flank pain; the dose is not stated in the abstract.
    Pediatr Nephrol, 2025 · checked 2026-10-07 · we read the abstract
11. ev-crks-11 · Position of an expert body · expert narrative review · n = —
    Similar to the case report by Pritchard and Kalra [51], these additional case reports were confounded by medications, pre-existing kidney disease, concomitant supplement ingestion, inappropriate creatine dosages (e.g., 100 X recommended dose), and anabolic androgenic steroid use.
    
    Who: published case reports of renal dysfunction during creatine use
    Effect: case reports confounded; no adverse kidney effects at recommended doses in healthy people
    Certainty: Review by ISSN authors; does not write about stones separately; people with kidney disease are outside the conclusion.
    Journal of the International Society of Sports Nutrition, 2021, Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? · checked 2026-10-07 · we read the fulltext
12. ev-crks-12 · Position of an expert body · expert narrative review · n = —
    In summary, experimental and controlled research indicates that creatine supplementation, when ingested at recommended dosages, does not result in kidney damage and/or renal dysfunction in healthy individuals.
    
    Who: healthy individuals at recommended creatine doses
    Effect: no kidney damage or renal dysfunction at recommended dosages
    Certainty: A conclusion about kidney function, not about stones.
    Journal of the International Society of Sports Nutrition, 2021, Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? · checked 2026-10-07 · we read the fulltext